The nation's largest veteran groups joined key senators Wednesday to endorse conditionally a plan by VA Secretary David Shulkin to replace the unpopular 2014 Choice program, which critics say often fails to provide timely access to private care when VA care isn't readily available.
However, veteran groups oppose VA's plan to fund the Choice replacement plan by cutting disability compensation paid through the Individual Unemployability program to 208,000 severely disabled veterans, those ages 62 and older who also are eligible for at least minimum Social Security benefits.
In testimony before the Senate Veterans Affairs Committee, Shulkin unveiled his replacement for Choice, titled the Veterans Coordinated Access and Rewarding Experiences Program. The program would have the familiar features to a managed-care program, with VA health care providers assigned to patients and deciding, based on clinical needs, whether to treat patients inside VA or refer them to an outside network of private-sector care providers under contract to VA.
VA is asking Congress to scrap the "arbitrary" mandates established under Choice to offer access to private-sector health care if veterans live more than 40 miles from a VA hospital or VA clinic staffed by a primary care provider, or if they must wait longer than 30 days for access to VA care after seeking an appointment.
Shulkin insisted under intense grilling by Sen. Mike Rounds, R-S.D., that patient choice to seek community care or to stay in VA would be preserved under the proposal because, he said, VA care providers wouldn't be implementing the program properly if they simply mandated the source of care for patients.
Rounds suggested veterans in his rural state finally are seeing the Choice plan work for them. If those same veterans are required again to consult with a VA provider, either in person or by phone, to get permission to seek outside care, "it doesn't sound like it's a joint decision," Rounds said.
Shulkin insisted it will be. VA will give guidance to providers to make it so.
Also, under the new plan, if a local VA facility can't treat a patient, the VA provider would grant permission to use the outside provider network.
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